Dichotomous Categorization Research Articles

Gold Coast Criteria in ALS Diagnosis: A Real-World Experience

Background: Revised El Escorial (rEEC) and Awaji criteria are currently used for diagnosing and categorizing amyotrophic lateral sclerosis (ALS). However, they are complex; their sensitivity is still not optimal for research purposes, and they present high inter-rater variability in clinical practice. To address these points, in 2019, a new set of diagnostic criteria was proposed, namely the Gold Coast criteria (GCC), characterized by a dichotomous diagnostic categorization, i.e., ALS or not ALS. Methods: In order to investigate the sensitivity, specificity, and clinical usefulness of GCC in a practical clinical setting, we retrospectively evaluated 131 patients diagnosed with ALS and 104 control subjects. ALSFRS-R score, electrophysiological tests, neuroradiological investigations, and CSF analysis were obtained. rEEC, Awaji, and GCC were applied at the first and last evaluations. Results: The sensitivity of GCC (93.1%; 96.1%) was greater than rEEC (71.8%; 87%) and Awaji criteria (77.8%; 89.3%) both at the first visit and last follow-up. The GCC’s specificity (28.8%) is lower than that of the other two criteria (rEEC 45.2%; Awaji 43.3%). Conclusions: Our study suggests that in a real-world setting, the GCC are more sensitive and have substantially lower risk of false negative diagnoses than rEEC and Awaji criteria. Although rEEC had the highest specificity, they may delay the diagnosis. Systematically using the GCC could help to achieve an earlier diagnosis and quickly refer patients to the correct management. The low specificity of GCC is likely to not significantly impact patient recruitment in clinical trials; therefore, its use might allow a faster and earlier enrollment.

Methodological Variations to Explore Conflicting Results in the Existing Literature of Masking Smile Judgment.

Although a smile can serve as an expression of genuine happiness, it can also be generated to conceal negative emotions. The traces of negative emotion present in these types of smiles can produce micro-expressions, subtle movements of the facial muscles manifested in the upper or lower half of the face. Studies examining the judgment of smiles masking negative emotions have mostly employed dichotomous rating measures, while also assuming that dichotomous categorization of a smile as happy or not is synonymous with judgments of the smile's authenticity. The aim of the two studies was to explore the judgment of enjoyment and masking smiles using unipolar and bipolar continuous rating measures and examine differences in the judgment when instruction varied between judgments of happiness and authenticity. In Experiment 1, participants rated smiles on 7-point scales on perceived happiness and authenticity. In Experiment 2, participants rated the smiles on bipolar 7-point scales between happiness and a negative emotion label. In both studies, similar patterns were observed: faces with traces of fear were rated significantly less happy/authentic and those with traces of anger in the brows were rated significantly happier/more authentic. Regarding varied instruction type, no effect was found for the two instruction types, indicating that participants perceive and judge enjoyment and masking smiles similarly according to these two instructions. Additionally, the use of bipolar scales with dimensions between a negative emotion label and happiness were not consistently effective in influencing the judgement of the masking smile.

Effect of sleep quality on repetitive transcranial magnetic stimulation outcomes in depression.

While repetitive transcranial magnetic stimulation (rTMS) is effective for 50-60% of those treatment-resistant depression, it is critical to identify predictors of response for optimal patient selection to improve therapy. Insomnia is a known symptom of depression that is both correlated with depression severity and associated with poor antidepressant response. Therefore, understanding this relationship may open new opportunities for the optimization of rTMS treatment. We aimed to explore whether baseline sleep quality, specifically insomnia, is associated with rTMS outcomes in a naturalistic sample of 975 patients (age 18-90; 63.9% F) receiving a standard course of rTMS treatment from two outpatient TMS clinics located within psychiatric hospitals in the United States. One site additionally collected information on concurrent medication use on 350 patients; among these, we examined whether pharmacological treatment of insomnia affected TMS treatment response. Depression was measured using the 30-item Inventory of Depressive Symptomology Self Report (IDS-SR) in site one and an abbreviated 16-item Quick Inventory of Depressive Symptomology (QIDS) derived from the IDS-SR in site two. Sleep disturbances were measured using three insomnia-related questions. Multilevel logistic regression was used to determine whether baseline insomnia scores were associated with TMS treatment outcome. Upon dichotomous categorization of the sample by insomnia and sleep-medication use, depression and sleep scores were analyzed across time using mixed repeated measures ANOVA. We found that sleep quality improves after TMS (p<.001) and correlates with improvement in non-insomnia related depression symptoms (r= .318, p<.001). We found that among those who had significant insomnia at baseline, those not using sleep medications had significantly worse post-treatment IDS-SR scores compared to those using sleep medications (p=. 021) despite no difference in final insomnia score. Together, our results suggest that while baseline insomnia is not associated with TMS effectiveness, treating insomnia may affect the trajectory of TMS therapy. Future prospective studies are needed to examine the effect of insomnia treatment alongside TMS for depression.

Purity and pollution: faith vegans’ categorizations of plant-based foods as pure and animal-derived foods as polluting

ABSTRACT Veganism has increased exponentially in the UK in recent years and whilst studies have attended to the redefinition of edibility and the adoption of new relationships with foodstuffs, one area that is noticeably absent from academic scholarship is the intersection with religion. Considering the influence that religion has on understandings of edibility, permissibility, and consumption, research gaps emerge pertaining to how religion and veganism come together to reshape the perceptions and categorizations of food types by vegans of faith. This article draws on a sociological study which recruited 12 Muslim vegans, 12 Jewish vegans, and 12 Christian vegans in the UK and conducted semi-structured qualitative interviews, diary methods, and virtual participant observation to gain a holistic understanding of the faith vegan experience. This article’s main finding is a dichotomous categorization of food types by faith vegans, with plant-based foods being seen as pure and animal-derived products being seen as polluting and inedible. Further, these understandings are intertwined with religious ethics, principles, and teachings in order to construct veganism as both God’s ideal diet and correct religious observance, whilst animal consumption is constructed as human greed, weakness, and a violation of what is perceived to be the ethical spirit of religion.

Longitudinal effects of prenatal alcohol exposure on visual neurodevelopment over infancy.

Prenatal alcohol exposure (PAE) affects neurodevelopment in over 59 million individuals globally. Prior studies using dichotomous categorization of alcohol use and comorbid substance exposures provide limited knowledge of how prenatal alcohol specifically impacts early human neurodevelopment. In this longitudinal cohort study from Cape Town, South Africa, PAE is measured continuously-characterizing timing, dose, and drinking patterns (i.e., binge drinking). High-density electroencephalography (EEG) during a visual-evoked potential (VEP) task was collected from infants aged 8 to 52 weeks with prenatal exposure exclusively to alcohol and matched on sociodemographic factors to infants with no substance exposure in utero. First trimester alcohol exposure related to altered timing of the P1 VEP component over the first 6 months postnatally, and first trimester binge drinking exposure altered timing of the P1 VEP components such that increased exposure was associated with longer VEP latencies while increasing age was related to shorter VEP latencies (n = 108). These results suggest alcohol exposure in the first trimester may alter visual neurodevelopmental timing in early infancy. Exploratory individual-difference analysis across infants with and without PAE tested the relation between VEP latencies and myelination for a subsample of infants with usable magnetic resonance imaging (MRI) T1w and T2w scans collected at the same time point as EEG (n = 47). Decreased MRI T1w/T2w ratios (an indicator of myelin) in the primary visual cortex (n = 47) were linked to longer P1 VEP latencies. Results from these two sets of analyses suggest that prenatal alcohol and postnatal myelination may both separately impact VEP latency over infancy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The influence of negotiation approaches on supplier relationship management in Zimbabwe’s fast-food industry

Abstract Supplier Relationship Management (SRM) has become a cornerstone of business success since the transformation of the procurement function to supply chain management. Extant literature has documented various predictors of vibrant supplier relationships. However, missing in the extant literature is the potential of negotiation approaches to cultivation of healthy supplier relationships. This study therefore sought to determine the influence of negotiation approaches on SRM. A sample of 150 dyadic transactions in the fast-food restaurant industry was surveyed. The broad dichotomous categorisation of negotiation methods into distributive and integrative approaches was used. SRM was operationalised using dimensions such as commitment, trust, communication, adaptation, and satisfaction. After conducting a Multivariate Analysis of Variance (MANOVA) the results revealed that the distributive strategy was weakly linked to supplier relationship, while a strong supplier relationship was observed in the use of integrative negotiation strategy. It was therefore recommended that procurement practitioners must employ integrative negotiation strategies and tactics in order to create sustainable supplier relationship management.

A review of the impact of decision heuristics on calorie underestimation and the implications for unhealthy eating

PurposeThe global rise in obesity can be closely linked to excessive calorie consumption and misperceptions regarding food intake. Thus, the purpose of this paper is to review the existing literature to have a better understanding how heuristic cues – mental shortcuts used for decision-making – impact calorie underestimation and consequently lead to unhealthy eating habits.Design/methodology/approachA search was conducted across multiple databases with priority given to studies in developed countries that provided insights into the cognitive processes behind food choices, the application of specific heuristics, and the association with eating behaviours. Articles were also selected based on their methodological quality.FindingsThe main findings are that the dichotomous categorization of foods as healthy or unhealthy can result in underestimating the calorie content in those foods perceived as healthy. Although nutrition claims, health claims and campaigns help in the fight against obesity, there is also the risk that consumers’ reliance on heuristic-based decision-making could aggravate the problem because a misinterpretation or misrepresentation could lead to calorie underestimation and overeating.Practical implicationsTo establish effective behavioural interventions for obesity prevalence -, it is critical for interventions and policies to understand how consumers perceive calorie content and how they interpret claims on food marketing or packaging. Recognizing and addressing these heuristic-driven biases and understanding the factors influencing food choices are crucial for encouraging healthier eating habits.Originality/valueTo the best of the authors’ knowledge, this paper is the only review to date that consolidates research on the topic, drawing from multiple disciplines.

Behind the technocratic challenge: Old and new alternatives to party government in Italy

The growing presence of technocrats in contemporary governments has emerged as a relevant phenomenon worldwide. Italy, once known as a paradigmatic case of party government and now identified as the promised land of technocracy, constitutes a crucial case to test the major short-term (critical junctures) and long-term (complexity of policy-making; party decline) factors identified to explain this phenomenon. Our analysis is based on two innovative tools: a new dataset updated to the current back-to-politics Meloni Italian government, including all the cases of the ‘technocratic decade’ (2010s); and a new typology combining partisanship and expertise, which allows us to overcome dichotomous categorizations equating technocrats and non-partisans. This more accurate and updated picture of minister profiles in Italy unveils unexpected dynamics and allows us to reassess both previous findings on the Italian case and the explanatory power of the tested theories on the growing diffusion of technocrats in contemporary governments.

Longitudinal medication adherence group-based trajectories of aging adults in the US: A retrospective analysis using monthly proportion of days covered calculations

BackgroundIt is thought that half of the patients with chronic conditions are not adherent to their medications, which contributes to significant health and economic burden. Many studies estimate medication non-adherence by implementing a threshold of ≥80% of Proportion of Days Covered (PDC), categorizing patients as either adherent or non-adherent. Healthcare quality metrics pertaining to medication use are based on this dichotomous approach of medication adherence, including the Medicare Part D Star Ratings. Among others, the Medicare Part D Star Ratings rewards part D plan sponsors with quality bonus payments based on this dichotomous categorization of beneficiaries’ medication adherence. ObjectivesDescribe the longitudinal adherence trajectories of adults ≥65 years of age covered by Medicare for 3 classes of drugs in the Part D Star Ratings: diabetes medications, statins, and select antihypertensives. MethodsThis study used Medicare healthcare administrative claims data linked to participants from the Health Retirement Study between 2008 and 2016. Group-based trajectory models (GBTM) elicited the number and shape of adherence trajectories from a sample of N = 11,068 participants for the three pharmacotherapeutic classes considered in this study. Medication adherence was estimated using monthly PDC. ResultsGBTM were estimated for the sample population taking antihypertensives (n = 7,272), statins (n = 8,221), and diabetes medications (n = 3,214). The hypertension model found three trajectories: high to very high adherence (47.55%), slow decline (32.99%), and rapid decline (19.47%) trajectories. The statins model found 5 trajectories: high to very high adherence (35.49%), slow decline (17.12%), low then increasing adherence (23.58%), moderate decline (12.62%), and rapid decline (11.20%). The diabetes medications model displayed 6 trajectories: high to very high adherence (24.15%), slow decline (16.84%), high then increasing adherence (25.56%), low then increasing (13.58%), moderate decline (10.60%), and rapid decline (9.27%). ConclusionsThis study showed the fluid nature of long-term medication adherence to the medications considered in the Medicare Part D Star Ratings and how it varies by pharmacotherapeutic class. These challenge previous assumptions about which patients were considered adherent to chronic medications. Policy and methodological implications about medication adherence are discussed.

90 Self-Rated Executive Dysfunction in Older Adults with Subjective Cognitive Dysfunction and Mild Cognitive Impairment

Objective:Mild cognitive impairment (MCI) is characterized by subjective and objective memory concerns, though additional cognitive concerns are commonly reported, including changes in executive functions (EF). Rabin et al. (2006) showed that a sample of research participants with MCI endorsed problems with their EFs, especially working memory. Similarly, those with subjective cognitive dysfunction (SCD) also reported greater difficulty with aspects of their EF than a healthy comparison sample of older adults (HC). In the present study, we investigated subjective EF in clinical samples of older adults with MCI or SCD, which represents a more naturalistic sample relative to a research sample. Furthermore, we evaluated whether subjective EF varied in these groups depending on whether patients were "young-old" versus "old-old" given prior research indicating objective cognitive differences between these age groups.Participants and Methods:Participants were 135 older adults (53 MCI, 52 SCD, and 30 HC) matched for age (p = .116) and education (p = .863). Dichotomous categorization of age used the sample median (72 years) as cutoff score with 72 participants in the young-old group (mean age = 65.8 ± 4.7 years) and 63 in the old-old group (mean age = 78.1 ± 3.7 years). Participants completed the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A), assessing executive functions in everyday life over the past month. The BRIEF-A yields an overall score (Global Executive Composite [GEC]) composed of two index scores (Behavioral Regulation Index [BRI] and Metacognition Index [MI]) and nine clinical scales (Inhibit, Shift, Emotional Control, Self-Monitor, Initiate, Working Memory, Plan/Organize, Task Monitor, and Organization of Materials). A diagnosis by age-group multivariate analysis of variance (MANOVA) with post-hoc comparisons for diagnosis using a Tukey HSD correction was conducted using SPSS Version 24.Results:MCI and SCD groups endorsed worse EF on all three index scores (ps &lt; .005) and all nine clinical scales (ps &lt; .05) relative to the HC group, and the MCI group reported worse initiation relative to the SCD group. Additionally, worse executive functions on all three index scores (ps &lt; .05) and four clinical scales (ps &lt; .05; emotional control, self-monitoring, planning/organization, and task monitoring) were reported by the young-old group relative to the old-old group. No diagnosis by age-group interactions were observed.Conclusions:Problems with aspects of EF were endorsed by older adults with MCI and SCD compared to HCs across all indices and clinical scales; however, only initiation was reported to be worse in MCI than those with SCD. Additionally, the young-old group endorsed having worse EF than the old-old group across BRIEF-A indices and several more specific aspects of EF, without a moderating effect of diagnosis. These findings highlight the importance of assessing subjective EF in older adults, as they may be early indicators of cognitive change, prior to objective evidence of cognitive decline. Furthermore, results also point to differences in how the young-old and old-old perceive their EF in everyday life.

Resource entanglement and indeterminacy: Advancing the service-dominant logic through the philosophy of Karen Barad

Resources are central to value creation processes. Hence, marketing and service research rely heavily on conceptualisations of resources and resource integration for theory building efforts. One of the most widely accepted marketing lenses on resources and resource integration is the service-dominant (S-D) logic. Depicting resources as becoming and contextual, S-D logic argues that their usefulness co-depends on other resources. Some assumptions of S-D logic have been challenged particularly its dichotomous categorisation of operand and operant resources. To inform ongoing S-D logic theorising, our article problematises the multiple and contradictory ontological views upon resources and resource integration present within S-D logic. Moving beyond critique, we propose concrete means for reconciling these contradictions. Seeing a parallel between S-D logic’s ontological inconsistencies and past ontological disagreements in the philosophy of science, we draw on the philosophical perspective of Karen Barad to develop a consistent onto-epistemological foundation for conceptualising the becoming nature of resources in S-D logic. The theory adaptation we perform enhances the applicability and explanatory capacity of S-D logic, while also offering a more robust and rigorous foundation for marketing and service research at large and giving managers new means to make sense of co-dependent resource phenomena.

Asthma Quality Measurement and Adverse Outcomes in Medicaid-Enrolled Children.

To determine the association between the asthma medication ratio (AMR) quality measure and adverse outcomes among Medicaid-enrolled children with asthma in Arkansas, given concerns regarding the utility of the AMR in evaluating pediatric risk of asthma-related adverse events (AAEs). We used the Arkansas All-Payer Claims Database to identify Medicaid-enrolled children with asthma using a nonrestrictive case definition and additionally using the standard Healthcare Effectiveness Data and Information Set (HEDIS) persistent asthma definition. We assessed the AMR using the traditional dichotomous HEDIS AMR categorization and across 4 expanded AMR categories. Regression models assessed associations between AMR and AAE including hospitalization and emergency department utilization, with models conducted overall and by race and ethnicity. Of the 22 788 children in the analysis, 9.0% had an AAE (6.7% asthma-related emergency department visits; 3.0% asthma-related hospitalizations). We found poor correlation between AMR and AAE, with higher rates of AAE (10.5%) among children with AMR ≥0.5 compared with AMR <0.5 (8.5%; P < .001), and similar patterns stratified by racial and ethnic subgroups. Expanded AMR categorization revealed notable differences in associations between AMR and AAEs, compared with traditional dichotomous categorization, with worse performance in Black children. The AMR performed poorly in identifying risk of adverse outcomes among Medicaid-enrolled children with asthma. These findings underscore concerns of the utility of the AMR in population health management and reliance on restrictive HEDIS definitions. New population health frameworks incorporating broader considerations that accurately identify at-risk children are needed to improve equity in asthma management and outcomes.

DecolonialMovidas: María Lugones's Notion of Decolonial Aesthesis through Cosmologies

Decolonial<i>Movidas</i>: María Lugones's Notion of Decolonial Aesthesis through Cosmologies

“Sularda yaşamak için yaratılmış gibi”: William Shakepeare’in Hamlet adlı oyununda Ophelia’nın ölümüne maddeci feminist bir yaklaşım

The purpose of this paper is to bring the material, specifically the materiality of the human body and the natural world, to the forefront within the context of material feminist theory and practices in William Shakespeare’s renowned play Hamlet. Drawing on material feminist literary criticism as the principle guiding paradigm, this paper explores the manner in which Ophelia’s entanglement with the material world in Hamlet offers fresh insights into the reconsideration of many dichotomous categorizations, including culture/nature, man/woman, and human/nonhuman. In this regard, this paper, which draws mainly upon material feminisms’ notions of “trans-corporeality,” “diffraction apparatus,” and “thing power,” considers the materiality of the bodies an active force, Thus, this paper provides a critical perspective on Shakespeare’s conventional representation of Ophelia’s death. By paying particular attention to Ophelia’s entanglement with the natural world in Hamlet, this paper indicates that the reconceptualization of Ophelia’s entanglement with water in her drowning scene within the context of material feminist theory can offer a sense of fluidity, mobility, and dynamism between dichotomous categorizations.

Prevalence, Risk Factors, and Outcomes of Airway Versus Non-Airway Pediatric Extubation Failure.

Pediatric extubation failure is associated with morbidity and mortality. The most common cause is upper-airway obstruction. Subglottic edema is common, but upper-airway obstruction can occur from the oral cavity to the trachea. Dichotomous categorization of extubation failure as airway versus non-airway may help identify risk factors as well as strategies that translate to lower extubation failure rates. This was as single-center, retrospective cohort study of invasive mechanical ventilation encounters within a quality improvement database between October 1, 2017-November 30, 2020. Utilizing a 3-physician adjudication process, all extubation failures were categorized as airway versus non-airway. Primary outcome was failure subtype prevalence. Secondary outcome was failure subtype risk factors. Clinical outcomes were explored. The all-cause extubation failure rate was 10% in a cohort of 844 encounters. Airway and non-airway extubation failure represented 60.7% and 39.3%, respectively. Most airway failures were due to upper-airway obstruction (84.3%)-35.3% were supraglottic, 25.5% subglottic, and 23.5% mixed. Other causes of airway failure were airway patency/secretions (11.8%) and aspiration (3.9%). Non-airway failures were attributed to respiratory failure (75.8%), encephalopathy (15.2%), and other (9%). All-cause extubation failure was associated with dysgenetic/syndromic comorbidity (P = .005), ≥ 3 concurrent comorbid conditions (P = .007), indication for invasive ventilation (P < .001), and longer invasive mechanical ventilation duration (P < .001). Airway extubation failure was significantly associated with the presence of a respiratory comorbidity (P = .01) and Glasgow coma scale < 10 (P = .02). No significant non-airway failure risk factors were identified. Longer pediatric ICU (PICU) stay (P < .001) and PICU mortality (P < .001) were associated with all-cause extubation failure. No significant outcome associations with extubation failure subtype were identified. Airway extubation failure prevalence was 1.5 times higher than non-airway failure. Potential risk factors for airway failure were identified. These findings are hypothesis generating for future study focused on key evidence gaps and pragmatic bedside application.

Rogue Masks: Visualizing Multidisciplinary Studies

In April 2022 Sheku “Goldenfinger” Fofanah, an exceedingly talented artist largely unrecognized outside Sierra Leone, created one Ordehlay and two Fairy masquerade ensembles for a major international traveling exhibition currently titled New Masks Now: Artists Innovating Masquerade in Contemporary West Africa. Emerging from previous dissertation research, the planning of this exhibition project, and my training in visual studies, this essay explores Fofanah’s vibrant, multicultural urban masquerades as a parallel of my own scholarly journey toward the discipline of visual studies, and the necessity of resisting overdetermined paths and dichotomous categorizations to approach, research, understand, and present/contextualize African masquerade arts. Like my own pedagogical journey, Ordehlay is not linear, nor does it stay in any one lane. Such a rogue mask calls for a rogue discipline.

Anonymous view on transgender soldiers: content analysis of online news headlines and comments in South Korea

BackgroundThe inclusion of transgender soldiers in the military service raises a fundamental question about the dichotomous categorization of human sexes based on anatomy and gender role within a specialized organization where the most masculine is commonly accepted. In March 2021, Hee-Soo Byun, the first transgender soldier in Korea to come out in public, and who was forcefully discharged after gender affirming surgery, died by suicide. With no anti-discrimination laws, the cultural background of the Korean society hardly creates an LGBT (Lesbian, Gay, Bisexual, and Transgender) — friendly environment and shows a negative attitude towards gender minorities.MethodsA total of 193 online news article headlines were analyzed, and 1046 comments were categorized inductively based on the presented rationales.Results: Before Byun’s public appearance, the frequent use of provocative expressions, which could evoke prejudice and discrimination, was found in published article headlines. Of the 724 comments that presented opinions on transgender soldiers, approximately 75% opposed Byun serving in the military in any form, including as a female soldier.ConclusionsThis study aimed to investigate online news articles and the comments regarding Byun’s case to estimate the acceptability of transgender people serving in the military. The results of this study are expected to serve as a basis for the formulation of policies that protect the human rights of transgender people.

Metallica the state/Metallica the war machine: A Deleuzoguattarian analysis of the world’s biggest metal band

Metallica has offered a diverse catalogue of music and breadth of performance over their careers. As a band occupying an integral cultural placement as measured by both level of fame and influential import, many academic inroads have been opened to their work, career and music. These lines of inquiry, along with more general lines of inquiry into the genre of heavy metal itself, frequently position Metallica as the unofficial ambassadors of the music. However, despite the depth and breadth of research devoted to these areas, an underdeveloped opening exists when it comes to the potential parallels and connections between the music and actions of Metallica and the philosophical works of Gilles Deleuze and Felix Guattari, specifically their notions of the state and the nomadic war machine. These theories serve as the basis of exploration in this research and provide new considerations and perspectives of both the career of Metallica and the larger implications to the study of popular music. The relations between Deleuze and Guattari and popular music offer many connections and examples, but the work of Metallica was selected as a representation of all of these connections as they are the ideal band from which to launch and develop these notions. Metallica is a group with clear distinctive phases to their career that fall within the concepts of the war machine (1981–91) and the state (1991–2008). While Metallica is not the only example of a band that falls into these dichotomous categorizations, they offer the best opportunity to define and clarify the connections to the ideas of Deleuze and Guattari. This can then be applied to other bands, genres of music and aspects of popular culture. Metallica is symbolic of this undertheorized connection to the works of Deleuze and Guattari. While these theoretical connections to the ideas of Deleuze and Guattari may not serve as the final piece to a full comprehension of the complexities of Metallica’s controversial career, they offer insights and open nascent pathways towards further analysis of the band. This is important because they have existed both on the fringes of marginalization and as a significant part of the discourse of popular culture.

Increased weight in patients with time-sensitive diagnosis is associated with longer prehospital on-scene times.

Obesity is a growing epidemic associated with higher rates of metabolic disease, heart disease and all-cause mortality. Heavier patients may require more advanced resources and specialized equipment. We hypothesize that increasing patient weight will be associated with longer prehospital on-scene times. We reviewed electronic patient care records for patients transported by two urban 9-1-1 emergency medical services (EMS) agencies. We collected age, sex, estimated patient weight, vital signs (systolic blood pressure, heart rate, pulse oximetry), provider impression, method of moving patient to ambulance, and on-scene times. We selected patients with time-sensitive diagnoses of stroke, ST-segment elevation myocardial infarction (STEMI), and trauma and compared on-scene times for patients who weighed above or below 300 pounds. We performed descriptive statistics, Mann-Whitney U tests for continuous variables and Chi-square tests for discrete variables. We constructed a generalized linear model to determine the effect of patient weight adjusted for covariates. For a three-year period (May 1, 2018 to April 30, 2021) 48,203 patients were transported with an EMS impression of stroke, ST-segment elevation myocardial infarction (STEMI), and trauma. 23,654 (49.1%) patients were female, and the median age was 52 (IQR 34-68) years. The median weight was 175.0 (IQR 150.0-205.0) pounds. Patients above a dichotomous weight categorization of 300 pounds experienced a longer median scene time with any time-sensitive diagnosis (12.6 versus 11.9 min p < 0.001), STEMI (16.0 versus 13.1 min, p = 0.014) and blunt trauma (12.6 versus 11.9 min, p < 0.001)). They were more likely to be hypoxic (p < 0.001) and more likely to experience cardiac arrest (p < 0.001). They were less likely to walk to the ambulance (22.1% versus 32.2%, p < 0.001). Patient weight above 300 pounds was associated with significantly longer on-scene time. These patients were more likely to be hypoxic, sustain a cardiac arrest, and less likely to walk to the ambulance.

Only baseline amyloid burdens and their incremental change could not predict AD progression in mild cognitive impairment

AbstractBackgroundMild cognitive impairment (MCI) is the intermediate stage between cognitively normal and dementia. Cerebral amyloid burden by amyloid PET is the pathological biomarker of Alzheimer’s disease (AD). The goal of this study was to evaluate the prognostic ability of baseline amyloid burdens and their incremental change in the MCI participants.MethodSeventy‐two MCI participants were selected in this study by inclusion and exclusion criteria. They underwent baseline and annual follow‐up evaluation including comprehensive neuropsychological assessment, consensus clinical diagnosis for 2 years. The [18F]Florbetaben PET and MRI scans were also performed. T1‐weighted MR 3D volumes were acquired for co‐registration with PET. Dichotomous categorization was performed for baseline β‐amyloid (Aβ) positivity by mean cortical amyloid burden cut‐off score. And annual amyloid burden changes were also acquired.ResultBaseline Aβ positivity evaluation defined 36 Aβ positive (Aβ+ve) and 36 Aβ negative (Aβ‐ve) MCI individuals. Of 36 Aβ+ve MCI subjects, 9 MCI progressed to AD and of 36 Aβ‐ve MCI subjects, 7 MCI progressed to AD (p = 0.280). MCI subjects with amyloid burden increase were 4 of 16 AD converters and 22 of 56 non‐converters (stable MCI) (p = 0.294).ConclusionOur results suggest that only baseline MCI amyloid burdens and their incremental change could not predict AD progression.